• Int. J. Cardiol. · Aug 2010

    Chronic obstructive pulmonary disease--an independent risk factor for long-term cardiac and cardiovascular mortality in patients with ischemic heart disease.

    • Kei Nishiyama, Takeshi Morimoto, Yutaka Furukawa, Yoshihisa Nakagawa, Natsuhiko Ehara, Ryouji Taniguchi, Neiko Ozasa, Naritatsu Saito, Kozo Hoshino, Masanao Touma, Toshihiro Tamura, Yoshisumi Haruna, Satoshi Shizuta, Takahiro Doi, Masanori Fukushima, Toru Kita, and Takeshi Kimura.
    • Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-chou, Shougoin, Sakyo-ku, Kyoto 606-8397, Japan. keinishi@kuhp.kyoto-u.ac.jp
    • Int. J. Cardiol. 2010 Aug 20;143(2):178-83.

    BackgroundLimited data are available on long-term mortality and morbidity of patients with chronic obstructive pulmonary disease (COPD) and ischemic heart disease. We examined how COPD affects long-term mortality and morbidity after undergoing percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).MethodsWe analyzed 9877 consecutive patients who underwent their first elective PCI (n=6878) and CABG (n=2999) in 2000-2002 at 30 institutions listed in the CREDO-Kyoto registry.ResultsCOPD was diagnosed in 240 patients (2.4%). In-hospital mortality (1.3% vs. 1.2%, p=0.972) did not differ between patients with and without COPD. During long-term follow-up (42. 8 month s), 906 patients (9.4%) died, 517 (5.3%) of whom died of cardiovascular death and 376 (3.9%), of cardiac death. At 3 years, the unadjusted survival rate and the rates of freedom from cardiovascular death and cardiac death were 92.1%, 95.3%, and 96.5% in the total population and 82.8%, 91.7%, and 92.1% in patients with COPD respectively. Log-rank test indicated that COPD was associated with higher incidence of all-cause mortality (p<0.0001), cardiovascular death (p=0.0002), and cardiac death (p<0.0001). Multivariate analyses indicated that COPD was an independent predictor of all-cause mortality (hazard ratio 1.36, p=0.0003), cardiovascular death (hazard ratio 1.28, p=0.0407), and cardiac death (hazard ratio 1.48, p=0.003).ConclusionsCOPD is an independent risk factor for long-term cardiac and cardiovascular mortality in patients with ischemic heart disease.Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

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